Homepage Blank Arizona Board Of Nursing License Form
Outline

The Arizona Board of Nursing License form is a critical document that facilitates the licensure process for nursing professionals in the state. This form encompasses various essential components, including definitions, time-frames for licensure, and specific requirements for different nursing roles. It outlines the procedures for obtaining licensure by examination or endorsement, ensuring that applicants understand the necessary steps to validate their qualifications. Additionally, the form addresses the standards related to nursing education programs, emphasizing the importance of accredited training and ongoing education. It also provides information on the regulatory framework governing nursing practice, including guidelines for advanced practice registered nursing and the responsibilities of certified nursing assistants. By detailing the expectations for licensure, renewal, and professional conduct, the Arizona Board of Nursing License form serves as a comprehensive guide for aspiring nurses, helping them navigate the complexities of entering and maintaining a career in nursing.

Sample - Arizona Board Of Nursing License Form

RULES OF THE
STATE BOARD OF NURSING
ISSUED BY
ARIZONA STATE BOARD OF NURSING
PHOENIX, ARIZONA
Updated: June 3, 2019
See Historical Notes after each Rule Section for
Official Effective Date of Rules
RULES June 3, 2019 Page 2 of 69
TITLE 4. PROFESSIONS AND OCCUPATIONS
CHAPTER 19. BOARD OF NURSING
(Authority: A.R.S. § 32-1606 et seq.)
ARTICLE 1. DEFINITIONS AND TIME-FRAMES
New Article 1, consisting of R4-19-101, adopted effective July 19, 1995 (Supp. 95-3).
Article 1, consisting of R4-19-101 through R4-19-102, repealed effective July 19, 1995 (Supp. 95-3).
Section
R4-19-101. Definitions
R4-19-102. Time-frames for Licensure, Certification, or Approval
Table 1. Time-frames
ARTICLE 2. ARIZONA REGISTERED AND PRACTICAL NURSING PROGRAMS; REFRESHER PROGRAMS
Article 2, consisting of R4-19-201 through R4-19-214, adopted effective July 19, 1995 (Supp. 95-3).
Section
R4-19-201. Organization and Administration
R4-19-202. Repealed
R4-19-203. Administrator; Qualifications and Duties
R4-19-204. Repealed
R4-19-205. Students; Policies and Admissions
R4-19-206. Curriculum
R4-19-207. New Programs; Proposal Approval; Provisional Approval
R4-19-208. Full Approval of a New Nursing Program
R4-19-209. Nursing Program Change
R4-19-210. Renewal of Approval of Nursing Programs Not Accredited by a National Nursing Accrediting Agency
R4-19-211. Unprofessional Conduct in a Nursing Program; Reinstatement or Reissuance
R4-19-212. Repealed
R4-19-213. Nursing Programs Holding National Program Accreditation; Changes in Accreditation
R4-19-214. Pilot Programs for Innovative Approaches in Nursing Education
R4-19-215. Voluntary Termination of a Nursing Program or a Refresher Program
R4-19-216. Approval of a Refresher Program
R4-19-217 Distance Learning Nursing Programs; Out-of-State Nursing Programs
ARTICLE 3. LICENSURE
Article 3, consisting of R4-19-301 through R4-19-308, adopted effective July 19, 1995 (Supp. 95-3).
Section
R4-19-301. Licensure by Examination
R4-19-302. Licensure by Endorsement
R4-19-303. Requirements for Credential Evaluation Service (CES)
R4-19-304. Temporary License
R4-19-305. License Renewal
R4-19-306. Inactive License
R4-19-307. Repealed
R4-19-308. Change of Name or Address
R4-19-309. School Nurse Certification Requirements
R4-19-310. Certified Registered Nurse
R4-19-311. Nurse Licensure Compact
R4-19-312. Practice Requirement
R4-19-313 Background
ARTICLE 4. REGULATION
Article 4, consisting of R4-19-401 through R4-19-404, adopted effective July 19, 1995 (Supp. 95-3).
Section
R4-19-401. Standards Related to Licensed Practical Nurse Scope of Practice
R4-19-402. Standards Related to Registered Nurse Scope of Practice
R4-19-403. Unprofessional Conduct
R4-19-404. Re-issuance or Subsequent Issuance of License
R4-19-405. Board-ordered Evaluations
RULES June 3, 2019 Page 3 of 69
ARTICLE 5. ADVANCED PRACTICE REGISTERED NURSING
Section
R4-19-501. Roles and Population Foci of Advanced Practice Registered Nursing (APRN); Certification Programs
R4-19-502. Requirements for APRN Programs
R4-19-503. Application for Approval of an Advanced Practice Registered Nursing Program; Approval by Board
R4-19-504. Notice of Deficiency; Unprofessional Program Conduct
R4-19-505. Requirements for Initial APRN Certification
R4-19-506. Expiration of APRN Certificate; Practice Requirement; Renewal
R4-19-507. Temporary Advanced Practice Certificate; Temporary Prescribing and Dispensing Authority
R4-19-508. Standards Related to Registered Nurse Practitioner Scope of Practice
R4-19-509. Delegation to Medical Assistants
R4-19-510. Expired
R4-19-511. Prescribing and Dispensing Authority; Prohibited Acts
R4-19-512. Prescribing Drugs and Devices
R4-19-513. Dispensing Drugs and Devices
R4-19-514. Standards Related to Clinical Nurse Specialist Scope of Practice
R4-19-515. Repealed
R4-19-516. Repealed
ARTICLE 6. RULES OF PRACTICE AND PROCEDURE
Article 6, consisting of R4-19-601 through R4-19-615, adopted effective October 10, 1996 (Supp. 96-4).
Section
R4-19-601. Expired
R4-19-602. Letter of Concern
R4-19-603. Representation
R4-19-604. Notice of Hearing; Response
R4-19-605. Expired
R4-19-606. Expired
R4-19-607. Recommended Decision
R4-19-608. Rehearing or Review of Decision
R4-19-609. Effectiveness of Orders
R4-19-610. Expired
R4-19-611. Expired
R4-19-612. Renumbered
R4-19-613. Expired
R4-19-614. Renumbered
R4-19-615. Renumbered
ARTICLE 7. PUBLIC PARTICIPATION PROCEDURES
Article 7, consisting of R4-19-701 through R4-19-706, adopted effective October 10, 1996 (Supp. 96-4).
Section
R4-19-701. Expired
R4-19-702. Petition for Rulemaking; Review of Agency Practice or Substantive Policy Statement; Objection to Rule Based Upon
Economic, Small Business, or Consumer Impact
R4-19-703. Oral Proceedings
R4-19-704. Petition for Altered Effective Date
R4-19-705. Written Criticism of an Existing Rule
R4-19-706. Renumbered
ARTICLE 8. CERTIFIED AND LICENSED NURSING ASSISTANTS AND CERTIFIED MEDICATION ASSISTANTS
Article 8, consisting of Sections R4-19-801 through R4-19-815, adopted by final rulemaking at 6 A.A.R. 757, effective February 4,
2000 (Supp. 00-1).
Section
R4-19-801. Common Standards for Nursing Assistant (NA) and Certified Medication Assistant (CMA) Training Programs
R4-19-802. Nursing Assistant (NA) Program Requirements
R4-19-803. Certified Medication Assistant Program Requirements
R4-19-804. Initial Approval and Re-approval Training Programs
R4-19-805. Deficiencies and Rescission of Program Approval, Unprofessional Program Conduct, Voluntary Termination, Disciplinar
y
Action, and Reinstatement
R4-19-806. Initial Nursing Assistant Licensure and Medication Assistant Certification
RULES June 3, 2019 Page 4 of 69
ARTICLE 8. CERTIFIED AND LICENSED NURSING ASSISTANTS AND CERTIFIED MEDICATION ASSISTANTS
(continued)
Section
R4-19-807. Nursing Assistant Licensure and Medication Assistant Certification by Endorsement
R4-19-808. Fees Related to Certified Medication Assistant
R4-19-809. Nursing Assistant Licensure and Medication Assistant Certificate Renewal
R4-19-810. Certified Nursing Assistant Registry; Licensed Nursing Assistant Registry
R4-19-811. Repealed
R4-19-812. Change of Name or Address
R4-19-813. Performance of Nursing Assistant Tasks; Performance of Medication Assistant Tasks
R4-19-814. Standards of Conduct for Licensed Nursing Assistants and Certified Medication Assistants
R4-19-815. Reissuance or Subsequent Issuance of a Nursing Assistant License or Medication Assistant Certificate
RULES June 3, 2019 Page 5 of 69
ARTICLE 1. DEFINITIONS AND TIME-FRAMES
R4-19-101. Definitions
In addition to the definitions in A.R.S. § 32-1601, in this Chapter:
"Abuse" means a misuse of power or betrayal of trust, respect, or intimacy by a nurse, nursing assistant, or applicant that causes or is likely
to cause physical, mental, emotional, or financial harm to a client.
"Administer" means the direct application of a medication to the body of a patient by a nurse, whether by injection, inhalation, ingestion, or
any other means.
“Admission cohort’ means a group of students admitted at the same time to the same curriculum in a regulated nursing, nursing assistant, or
advanced practice nursing program or entering the first clinical course in a regulated program at the same time. “Same time” means on
the same date or within a narrow range of dates pre-defined by the program.
"Applicant" means a person seeking licensure, certification, prescribing, or prescribing and dispensing privileges, or an entity seeking
approval or re-approval, if applicable, of a:
CNS or RNP nursing program,
Credential evaluation service,
Nursing assistant training program,
Nursing program,
Nursing program change, or
Refresher program.
"Approved national nursing accrediting agency" means an organization recognized by the United States Department of Education as an
accrediting agency for a nursing program.
"Assign" means a nurse designates nursing activities to be performed by another nurse that are consistent with the other nurse's scope of
practice.
"Certificate or diploma in practical nursing" means the document awarded to a graduate of an educational program in practical nursing.
“Certified medication assistant” means a certified nursing assistant who meets Board qualifications and is additionally certified by the
Board to administer medications under A.R.S. § 32-1650 et. seq.
“CES” means credential evaluation service.
"Client" means a recipient of care and may be an individual, family, group, or community.
"Clinical instruction" means the guidance and supervision provided by a nursing, nursing assistant or medication assistant program faculty
member while a student is providing client care.
“CMA” means certified medication assistant.
“CNA” means a certified nursing assistant, as defined in A.R.S § 32-1601(4).
"CNS" means clinical nurse specialist, as defined in A.R.S. § 32-1601(7).
"Collaborate" means to establish a relationship for consultation or referral with one or more licensed physicians on an as-needed basis.
Supervision of the activities of a registered nurse practitioner by the collaborating physician is not required.
"Contact hour" means a unit of organized learning, which may be either clinical or didactic and is either 60 minutes in length or is
otherwise defined by an accrediting agency recognized by the Board.
"Continuing education activity" means a course of study related to nursing practice that is awarded contact hours by an accrediting agency
recognized by the Board, or academic credits in nursing or medicine by a regionally or nationally accredited college or university.
"CRNA" means a certified registered nurse anesthetist as defined in A.R.S. § 32-1601 (6).
"DEA" means the federal Drug Enforcement Administration.
"Dispense" means to deliver a controlled substance or legend drug to an ultimate user.
"Dual relationship" means a nurse or CNA simultaneously engages in both a professional and nonprofessional relationship with a patient or
resident or a patient’s or resident’s family that is avoidable,
non-incidental, and results in the patient or resident or the patient’s or
resident’s family being exploited financially, emotionally, or sexually.
“Eligibility for graduation” means that the applicant has successfully completed all program and institutional requirements for receiving a
degree or diploma but is delayed in receiving the degree or diploma due to the graduation schedule of the institution.
"Endorsement" means the procedure for granting an Arizona nursing license to an applicant who is already licensed as a nurse in another
state or territory of the United States and has passed an exam as required by A.R.S. §§ 32-1633 or 32-1638 or an Arizona nursing
assistant or medication assistant certificate to an applicant who is already listed on a nurse aide register or certified as a medication
assistant in another state or territory of the United States.
RULES June 3, 2019 Page 6 of 69
"Episodic nursing care" means nursing care at nonspecific intervals that is focused on the current needs of the individual.
"Failure to maintain professional boundaries" means any conduct or behavior of a nurse or CNA that, regardless of the nurse's or CNA's
intention, is likely to lessen the benefit of care to a patient or resident or a patient's or resident's family or places the patient, resident or
the patient's or resident's family at risk of being exploited financially, emotionally, or sexually;
“Family”, as applied to R4-9-511, means individuals who are related by blood, marriage, adoption, legal guardianship, or domestic
partnership, or who are cohabitating or romantically involved.
"Good standing" means the license of a nurse, or the certificate of a nursing assistant, is current, and the nurse or nursing assistant is not
presently subject to any disciplinary action, consent order, or settlement agreement.
"Independent nursing activities" means nursing care within an RN's scope of practice that does not require authorization from another
health professional.
"Initial approval" means the permission, granted by the Board, to an entity to establish a nursing assistant training program, after the Board
determines that the program meets the standards provided by A.R.S. Title 32, Chapter 15 and this Chapter.
"Licensure by examination" means the granting of permission to practice nursing based on an individual's passing of a prescribed
examination and meeting all other licensure requirements.
"LPN" means licensed practical nurse.
"NCLEX" means the National Council Licensure Examination.
"Nurse" means a licensed practical or registered nurse.
"Nursing diagnosis" means a clinical judgment, based on analysis of comprehensive assessment data, about a client's response to actual and
potential health problems or life processes. Nursing diagnosis statements include the actual or potential problem, etiology or risk
factors, and defining characteristics, if any.
"Nursing process" means applying problem-solving techniques that require technical and scientific knowledge, good judgment, and
decision-making skills to assess, plan, implement, and evaluate a plan of care.
"Nursing program" means a formal course of instruction designed to prepare its graduates for licensure as registered or practical nurses.
"Nursing program administrator" means a nurse educator who meets the requirements of A.R.S. Title 32, Chapter 15 and this Chapter and
has the administrative responsibility and authority for the direction of a nursing program.
"Nursing program faculty member" means an individual working full or part time within a nursing program who is responsible for either
developing, implementing, teaching, evaluating, or updating nursing knowledge, clinical skills, or curricula.
"Nursing-related activities or duties" means client care tasks for which education is provided by a basic nursing assistant training program.
"P & D" means prescribing and dispensing.
"Parent institution" means the educational institution in which a nursing program, or nursing assistant training program or medication
assistant program is conducted.
"Patient" means an individual recipient of care.
"Pharmacology" means the science that deals with the study of drugs.
"Physician" means a person licensed under A.R.S. Title 32, Chapters 7, 8, 11, 13, 14, 17, or 29, or by a state medical board in the United
States.
"Preceptor" means a licensed nurse or other health professional who meets the requirements of A.R.S. Title 32, Chapter 15 and this Chapter
who instructs, supervises and evaluates a licensee, clinical nurse specialist, nurse practitioner or pre-licensure nursing student, for a
defined period.
"Preceptorship" means a clinical learning experience by which a learner enrolled in a nursing program, nurse refresher program, clinical
nurse specialist, or registered nurse practitioner program or as part of a Board order provides nursing care while assigned to a health
professional who holds a license or certificate equivalent to or higher than the level of the learner's program or in the case of a nurse
under Board order, meets the qualifications in the Board order.
"Prescribe" means to order a medication, medical device, or appliance for use by a patient.
“Private business” means any individual or sole proprietorship, partnership, limited liability partnership, limited liability company,
corporation or other legal business entity.
"Proposal approval" means that an institution has met the standards provided by A.R.S. Title 32, Chapter 15 and this Chapter to proceed
with an application for provisional approval to establish a pre-licensure nursing program in Arizona.
"Provisional approval" means that an institution has met the standards provided by A.R.S. Title 32, Chapter 15 and this Chapter to
implement a pre-licensure nursing program in Arizona.
"Refresher program" means a formal course of instruction designed to provide a review and update of nursing theory and practice.
RULES June 3, 2019 Page 7 of 69
"Register" means a listing of Arizona certified nursing assistants maintained by the Board that includes the following about each nursing
assistant:
Identifying demographic information;
Date placed on the register;
Date of initial and most recent certification, if applicable; and
Status of the nursing assistant certificate, including findings of abuse, neglect, or misappropriation of property made by the Arizona
Department of Health Services, sanctions imposed by the United States Department of Health and Human Services, and
disciplinary actions by the Board.
"Resident" means a patient who receives care in a long-term care facility or other residential setting.
"RN" means registered nurse.
"RNP" means a registered nurse practitioner as defined in A.R.S. § 32-1601(20).
"SBTPE" means the State Board Test Pool Examination.
"School nurse" means a registered nurse who is certified under R4-19-309.
“Secure examination” means a written test given to an examinee that:
Is administered under conditions designed to prevent cheating;
Is taken by an individual examinee without access to aides, textbooks, other students or any other material that could influence the
examinee’s score; and,
After opportunity for examinee review, is either never used again or stored such that only designated employees of the educational
institution are permitted to access the test.
"Self-study" means a written self-evaluation conducted by a nursing program to assess the compliance of the program with the standards
listed in Article 2.
"Standards related to scope of practice" means the expected actions of any nurse who holds the identified level of licensure.
“Substance use disorder” means misuse, dependence or addiction to alcohol, illegal drugs or other substances.
"Supervision" means the direction and periodic consultation provided to an individual to whom a nursing task or patient care activity is
delegated.
"Unlicensed assistive personnel" or "UAP" means a CNA or any other unlicensed person, regardless of title, to whom nursing tasks are
delegated.
“Verified application” means an affidavit signed by the applicant attesting to the truthfulness and completeness of the application and
includes an oath that applicant will conform to ethical professional standards and obey the laws and rules of the Board.
Historical Note
Former Glossary of Terms; Amended effective Nov. 17, 1978 (Supp. 78-6). Former Section R4-19-01 repealed, new Section R4-19-01
adopted effective February 20, 1980 (Supp. 80-1). Amended paragraphs (1) and (7), added paragraphs (9) through (25) effective July 16,
1984 (Supp. 84-4). Former Section R4-19-01 renumbered as Section R4-19-101 (Supp. 86-1). Amended effective November 18, 1994
(Supp. 94-4). Section repealed, new Section adopted effective July 19, 1995 (Supp. 95-3). Amended effective December 22, 1995 (Supp.
95-4). Amended effective November 25, 1996 (Supp. 96-4). Amended by final rulemaking at 7 A.A.R. 1712, effective April 4, 2001 (Supp.
01-2). Amended by final rulemaking at 14 A.A.R. 4621, effective January 31, 2009 (Supp. 08-4). Pursuant to authority of A.R.S. § 41-
1011(C), Laws 2012, Ch. 152, § 1, provides for A.R.S. references to be corrected to reflect the renumbering of definitions. Th
erefore the
A.R.S. citations in the definitions of “CNA” “CNS” and “RNP” have been updated. Agency request filed July 12, 2012, Office File No.
M12-242 (Supp. 12-3). Amended by final rulemaking at 19 A.A.R. 1308 effective July 6, 2013 (Supp. 13-2). Amended by final rulemaking
at 20 A.A.R. 1859, effective September 8,2014 (Supp. 14-3). A.R.S. section references updated under Laws 2015, Ch. 262, effective July 1,
2016 (Laws 2015, Ch. 262, § 23) at file number R16-186 (Supp. 16- 3). Amended by final rulemaking at 23 A.A.R. 1420, effective July 1,
2017 (Supp. 17-2). Amended by final rulemaking at 25 A.A.R. 919, effective June 3, 2019; when amended the Board inadvertently left out
the definition of “Full Approval” as last amended at 14 A.A.R. 4621 4621 (Supp. 19-2).
R4-19-102. Time-frames for Licensure, Certification, or Approval
A. In this Section:
1. "Administrative completeness" or "administratively complete" means Board receipt of all application components required by
statute or rule and necessary to begin the substantive review time-frame.
2. "Application packet" means an application form provided by the Board and the documentation necessary to establish an
applicant's qualifications for licensure, certification, or approval.
3. "Comprehensive written request for additional information" means written communication after the administrative completeness
time-frame by the Board to an applicant in person or at the mailing or electronic address identified on the application notifying
the applicant that additional information, including missing documents is needed before the Board can grant the license. The
written communication shall:
RULES June 3, 2019 Page 8 of 69
a. Contain a list of information required by statute or rule and necessary to complete the application or grant the license, and
b. Inform the applicant that the request suspends the running of days within the time-frame, and
c. Be effective on the date of issuance which is:
i. The date of its postmark, if mailed;
ii. The date of delivery, if delivered in person by a Board employee or agent; or
iii. The date of delivery to the electronic address if delivered electronically.
4. "Deficiency notice" means written communication by the Board to an applicant in person or at the mailing or electronic address
identified on the application notifying the applicant that additional information, including missing documents, is needed to
complete the application. The written communication shall:
a. Contain a list of information required by statute or rule and necessary to complete the application or grant the license;
b. Inform the applicant that the request suspends the running of days within the time-frame; and
c. Be effective on the date of issuance which is:
i. The date of its postmark, if mailed;
ii. The date of delivery, if delivered in person by a Board employee or agent; or
iii. The date of delivery to the electronic address if delivered electronically.
5. "Notice of administrative completeness" means written communication by the Board to an applicant in person or at the mailing or
electronic address identified on the application notifying the applicant the application contains all information required by statute
or rule to complete the application.
6. "Overall time-frame" has the same meaning as A.R.S. § 41-1072(2).
7. "Substantive review time-frame" has the same meaning as A.R.S. § 41-1072(3).
B. In computing the time-frames in this Section, the day of the act or event from which the designated period begins to run is not
included. The last day of the period is included unless it is a Saturday, Sunday, or official state holiday, in which event the period runs
until the end of the next day that is not a Saturday, Sunday, or official state holiday.
C. For each type of licensure, certification, or approval issued by the Board, the overall time-frame described in A.R.S. § 41-1072(2) is
listed in Table 1. An applicant may submit a written request to the Board for an extension of time in which to provide a complete
application. The request for an extension of time shall be submitted to the Board office before the deadline for submission of a
complete application and shall state the reason that the applicant is unable to comply with the time-frame requirements in Table 1 and
the amount of additional time requested. The Board may grant an extension of time based on whether the Executive Director of the
Board finds that the applicant is unable to comply within the time-frame due to circumstances beyond the applicant's control and that
the additional information can reasonably be supplied during the extension of time.
D. For each type of licensure, certification, or approval issued by the Board, the administrative completeness review time-frame
described in A.R.S. § 41-1072(1) is listed in Table 1 and begins to run when the Board receives an application packet.
1. If the application packet is not administratively complete,
the Board shall send a deficiency notice to the applicant. The time for
the applicant to respond to a deficiency notice begins to run on the date the deficiency notice is issued.
a. The deficiency notice shall list each deficiency.
b. The applicant shall submit to the Board the missing information listed in the deficiency notice within the period specified in
Table 1 for responding to a deficiency notice. The time-frame for the Board to complete the administrative review is
suspended until the Board receives the missing information.
c. If an applicant fails to provide the missing information listed in the deficiency notice within the period specified in Table 1,
the Board shall close the applicant's file and send a notice to the applicant by U.S. mail and electronically, if an electronic
address is included in the application.
d. If the applicant is the subject of an investigation, the Board may continue to process the application. Failure of the applicant
to supply the requested information may result in denial of the license or certificate based on information gathered during
the investigation.
2. If the application packet is administratively complete, the Board shall send a written notice of administrative completeness to the
applicant.
3. If the Board issues a license, certificate, or approval during the administrative completeness review time-frame, the Board shall
not send a separate written notice of administrative completeness.
E. For each type of licensure, certification, or approval issued by the Board, the substantive review time-frame described in A.R.S. § 41-
1072(3) is listed in Table 1 and begins to run on the date the notice of administrative completeness is issued.
1. During the substantive review time-frame, an applicant may make a request to withdraw an application packet. The Board may
deny the request to withdraw an application packet if the applicant is the subject of an investigation, based on information
gathered during the investigation.
2. If an applicant discloses or the Board receives allegations of unprofessional conduct as described in A.R.S. § 32-1601 or this
Chapter, the Board shall review the allegations and may investigate the applicant. The Board may require the applicant to provide
additional information as prescribed in subsection (E)(3) based on its assessment of whether the conduct is or might be harmful
or dangerous to the health of a client or the public.
3. During the substantive review time-frame, the Board may make one comprehensive written request for additional information.
The applicant shall submit the additional information within the period specified in Table 1. The time-frame for the Board to
complete the substantive review of the application packet is suspended from the date the comprehensive written request for
additional information is issued until the Board receives the additional information.
4. If the applicant fails to provide the additional information identified in the comprehensive written request for additional
information within the time specified in Table 1, the Board shall close the applicant's file and send a notice to the applicant by
U.S. mail and electronically, if an electronic address is included in the application. The Board may continue to process the
RULES June 3, 2019 Page 9 of 69
application if the applicant is the subject of an investigation. Failure of the applicant to supply the requested information may
result in denial of the license or certificate based on information gathered during the investigation.
5. The Board shall grant licensure, conditional licensure, limited licensure, certification, or approval to an applicant:
a. Who meets the substantive criteria for licensure, certification, or approval required by A.R.S. Title 32, Chapter 15 and this
Chapter; and
b. Whose licensure, certification, or approval is in the best interest of the public.
6. The Board shall deny licensure, certification, or approval to an applicant:
a. Who fails to meet the substantive criteria for licensure, certification, or approval required by A.R.S. Title 32, Chapter 15 and
this Chapter; or
b. Who has engaged in unprofessional conduct as described in A.R.S. § 32-1601 or this Chapter; and
c. Whose licensure, certification, or approval is not in the best interest of the public.
7. The Board's written order of denial shall meet the requirements of A.R.S. § 41-1076. The applicant may request a hearing by
filing a written request with the Board within 30 days of receipt of the Board's order of denial. The Board shall conduct hearings
in accordance with A.R.S. Title 41, Chapter 6, Article 10 and 4 A.A.C. 19, Article 6.
Historical Note
Adopted effective February 20, 1980 (Supp. 80-1). Former Section R4-19-02 renumbered and amended as Section R4-19-102
effective February 21, 1986 (Supp. 86-1). Section repealed effective July 19, 1995 (Supp. 95-3). New Section adopted April
20, 1998 (Supp. 98-2). Amended by final rulemaking at 7 A.A.R. 1712, effective April 4, 2001 (Supp. 01-2). Amended by
final rulemaking at 14 A.A.R. 4621, effective January 31, 2009 (Supp. 08-4).
Table 1. Time-frames
Time-frames (in days)
Type of License,
Certificate, or
Approval
Applicable
Statute
and Section
Board
Overall Time-
frame
Without
Investigation
Board
Overall Time-
frame
With
Investigation
Board
Administrative
Completeness
Review
Time-frame
Applicant
Time to
Respond to
Deficiency
Notice
Board
Substantive
Review
Time-frame
Without
Investigation
Board
Substantive
Review
Time-frame
With
Investigation
Applicant
Time to
Respond to
Comprehensive
Written
Request
Nursing Program
Proposal Approval
A.R.S. §§ 32-
1606(B)(2), 32-
1644; R4-19-207
150
Not
Applicable
60 180 90
Not
applicable
120
Nursing Program
Provisional
Approval
A.R.S. §§ 32-
1606(B)(2), 32-
1644; R4-19-207
150
Not
applicable
60 180 90
Not
applicable
120
Nursing Program
Full Approval or
Re-approval
A.R.S. §§ 32-
1606(B)(2), 32-
1644; R4-19-208,
R4-19-210
150
Not
applicable
60 180 90
Not
applicable
120
Nursing Program
Change
A.R.S. § 32-
1606(B)(1);
R4-19-209
150
Not
applicable
60 180 90
Not
applicable
120
Refresher Program
Approval or
Re-approval
A.R.S. § 32-
1606(B)(21);
R4-19-216
150
Not
applicable
60 180 90
No
applicable
120
CNS or RNP
Nursing Program
Approval or
Re-approval
A.R.S. §§ 32
1606(B)(18),
32-1644; R4-19-
503
150
Not
applicable
60 180 90
Not
applicable
120
Credential
Evaluation Service
Approval or
Re-approval
A.R.S. §§ 32-
1634.01(A)(1),
32-1634.02(A)(1),
32-1639.01(1),
32-1639.02(1);
R4-19-303
90
Not
applicable
30 180 60
Not
applicable
120
Licensure by Exam
A.R.S. §§ 32-
1606(B)(5), 32-
1633, 32-1638,
and R4-19-301
150 270 30 270 120 240 150
Licensure by
Endorsement
A.R.S. §§ 32-
1606(B)(5), 32-
1634, 32-1639,
and R4-19-302
150 270 30 270 120 240 150
Temporary License
or Renewal
A.R.S. §§ 32-
1605.01(B)(3),
60 90 30 60 30 60 90
RULES June 3, 2019 Page 10 of 69
Time-frames (in days)
Type of License,
Certificate, or
Approval
Applicable
Statute
and Section
Board
Overall Time-
frame
Without
Investigation
Board
Overall Time-
frame
With
Investigation
Board
Administrative
Completeness
Review
Time-frame
Applicant
Time to
Respond to
Deficiency
Notice
Board
Substantive
Review
Time-frame
Without
Investigation
Board
Substantive
Review
Time-frame
With
Investigation
Applicant
Time to
Respond to
Comprehensive
Written
Request
32-1635, 32-1640;
R4-19-304
License Renewal
A.R.S. §§ 32-
1606(B)(5), 32-
1642; R4-19-305
120 270 30 270 90 240 150
School Nurse
Certification or
Renewal
A.R.S. §§ 32-1606
(B)(13), 32-1643
(A)(8); R4-19-309
150 270 30 270 120 240 150
Re-issuance or
Subsequent
Issuance of License
A.R.S. § 32-
1664(O);
R4-19-404
150 270 30 270 120 240 150
Registered Nurse
Practitioner
Certification or
Renewal
A.R.S. §§ 32-
1601(19), 32-
1606(B)(21);
R4-19-505, R4-
19-506
150 270 30 270 120 240 150
RNP Prescribing
and
Dispensing
Privilege
A.R.S. § 32-
1601(19);
R4-19-511
150 270 30 270 120 240 150
CNS Certification
or
Renewal
A.R.S. §§ 32-
1601(6), 32-
1606(B)(21); R4-
19-505, R4-19-
506
150 270 30 270 120 240 150
CRNA Certification
or Renewal
A.R.S. § 32-1634-
.03; R4-19-505;
R4-19-506
150 270 30 270 120 240 150
Temporary RNP,
CRNA or CNS
Certificate or
Renewal
A.R.S. § 32-
1635.01, 32-
1634.03; R4-19-
507
60
Not
applicable
30 60 30
Not
applicable
60
Nursing Assistant
and Medication
Assistant Training
Programs Approval
or Re-approval
A.R.S. § 32-
1606(B)(11), 32-
1650.01; R4-19-
803, R4-19-804
120
Not
applicable
30 180 90
Not
applicable
120
Licensed or
Certified Nursing
Assistant and
Medication
Assistant
Certification by
Examination
A.R.S. §§ 32-
1606(B)(11), 32-
1647, 32-1650.02,
32-1650.03; R4-
19-806
150 270 30 270 120 240 150
Licensed or
Certified Nursing
Assistant and
Medication
Assistant
Certification by
Endorsement
A.R.S §§ 32-
1606(B)(11), 32-
1648, 32-1650.04;
R4-19-807
150 270 30 270 120 240 150
Licensed or
Certified Nursing
Assistant and
Certified
Medication
Assistant Renewal
A.R.S. § 32-
1606(B)(11);
R4-19-809
120 270 30 270 90 240 150
Re-issuance or
Subsequent
Issuance of a
A.R.S. § 32-
1664(O); R4-19-
815
150 270 30 270 120 240 150

Form Information

Fact Name Details
Governing Law The Arizona Board of Nursing License form is governed by A.R.S. § 32-1606 et seq.
Effective Date The rules were adopted effective July 19, 1995, with updates made as of June 3, 2019.
Licensure Types Licensure can be obtained through examination or endorsement for registered and practical nurses.
Time-frames for Licensure Specific time-frames for licensure, certification, or approval are outlined in Section R4-19-102.
Approval of Nursing Programs Nursing programs must seek approval from the Board, as detailed in Article 2, Sections R4-19-207 to R4-19-210.
Continuing Education Requirements Continuing education activities must be recognized by an accrediting agency approved by the Board.
Advanced Practice Registered Nursing Requirements for APRN programs and certification are specified in Article 5 of the rules.

Detailed Guide for Filling Out Arizona Board Of Nursing License

Filling out the Arizona Board of Nursing License form is an important step in your journey to becoming a licensed nurse in Arizona. Make sure to have all necessary documents ready, as they will help you complete the form accurately. After you submit the form, it will be reviewed by the Board, and you will be notified of any further steps needed to finalize your application.

  1. Download the Arizona Board of Nursing License form from the official website.
  2. Read the instructions carefully to understand what information is required.
  3. Fill in your personal information, including your full name, address, and contact details.
  4. Provide your Social Security number and date of birth as requested.
  5. Indicate the type of nursing license you are applying for (e.g., Registered Nurse, Practical Nurse).
  6. List your educational background, including the nursing program you completed.
  7. Include details about any previous nursing licenses you hold, including the state and license number.
  8. Answer all questions regarding your background, including any criminal history or disciplinary actions.
  9. Attach any required documents, such as transcripts or proof of previous licensure.
  10. Review your completed form for accuracy and completeness.
  11. Sign and date the form at the bottom.
  12. Submit the form along with the required fee to the Arizona Board of Nursing.

Obtain Answers on Arizona Board Of Nursing License

  1. What is the Arizona Board of Nursing License form?

    The Arizona Board of Nursing License form is an official document required for individuals seeking to obtain a nursing license in Arizona. This form collects essential information about the applicant, including educational background, work experience, and any prior disciplinary actions. It is a critical step in the licensure process for registered nurses, licensed practical nurses, and nursing assistants.

  2. Who needs to complete this form?

    Any individual applying for a nursing license in Arizona must complete this form. This includes those seeking licensure by examination, endorsement, or renewal. The form is also applicable for certified nursing assistants and certified medication assistants.

  3. What information is required on the form?

    The form typically requires:

    • Personal identification details (name, address, date of birth)
    • Educational history, including nursing programs attended
    • Work experience in the nursing field
    • Details of any criminal history or disciplinary actions

    Providing accurate and complete information is crucial, as any discrepancies can delay the licensure process.

  4. How do I submit the Arizona Board of Nursing License form?

    The completed form can be submitted online through the Arizona Board of Nursing's official website or mailed directly to their office. It is important to check the specific submission guidelines and ensure that all required documents accompany the form.

  5. What is the processing time for the application?

    Processing times can vary based on several factors, including the volume of applications received. Typically, applicants can expect a processing time of 4 to 6 weeks. However, this may be longer if additional information or documentation is required.

  6. What happens if I make a mistake on the form?

    If an applicant realizes a mistake after submitting the form, it is advisable to contact the Arizona Board of Nursing as soon as possible. They can provide guidance on how to correct the error, which may involve submitting a revised form or additional documentation.

  7. Are there fees associated with submitting the form?

    Yes, there are fees associated with the application process. These fees vary depending on the type of license being applied for and must be paid at the time of submission. It is essential to review the current fee schedule on the Arizona Board of Nursing's website for accurate information.

  8. What if I have a criminal record?

    Individuals with a criminal record may still apply for a nursing license, but they must disclose this information on the application form. The Arizona Board of Nursing will review the circumstances surrounding the record and determine eligibility based on specific criteria. It is important to be transparent during this process.

  9. Can I check the status of my application?

    Yes, applicants can check the status of their application through the Arizona Board of Nursing's online portal. This feature allows individuals to see where their application is in the review process and if any additional information is needed.

Common mistakes

Completing the Arizona Board of Nursing License form can be a straightforward process, but many applicants inadvertently make mistakes that can delay their licensure. One common error is failing to provide accurate personal information. This includes not only your name and address but also your Social Security number. If the information doesn’t match official records, it could lead to complications in processing your application.

Another frequent mistake is neglecting to disclose previous disciplinary actions. Whether you have faced sanctions in the past or not, it's essential to be honest. Omitting this information can result in severe consequences, including denial of your application. Transparency is key, and the Board expects full disclosure.

Many applicants also overlook the importance of submitting required documentation. This includes transcripts, proof of nursing education, and any necessary certifications. If you miss a document, your application may be deemed incomplete, which can significantly prolong the review process.

In addition, applicants sometimes misinterpret the requirements for licensure by endorsement. If you are already licensed in another state, you must ensure that you meet Arizona's specific criteria. Failing to understand these requirements can lead to unnecessary confusion and delays.

Another common pitfall is not paying the required fees. Each application comes with its own set of fees, and applicants often forget to include payment or miscalculate the total amount. This oversight can halt the processing of your application until the fees are settled.

Many individuals also fail to double-check their application for errors before submission. Simple typos or mistakes can lead to significant issues. Taking the time to review your application can save you from unnecessary headaches down the line.

Some applicants might not be aware of the timeframes associated with the application process. Understanding how long each step takes can help you plan accordingly. If you are in a hurry, knowing the average processing time can help you manage your expectations.

Additionally, applicants sometimes underestimate the importance of keeping their contact information up to date. If the Board needs to reach you for any reason, having outdated contact information can lead to missed communications and delays.

Lastly, failing to follow up on your application status can also be a mistake. After submitting your application, it’s wise to check in periodically. This proactive approach can help you catch any issues early and keep your application moving forward.

Documents used along the form

The process of obtaining a nursing license in Arizona involves several important forms and documents. Each of these documents plays a vital role in ensuring that applicants meet the necessary requirements and standards set by the Arizona Board of Nursing. Below is a list of additional forms and documents commonly used alongside the Arizona Board of Nursing License form.

  • Application for Licensure by Examination: This document is required for individuals who are taking the nursing licensure exam for the first time. It includes details about the applicant's education and qualifications.
  • Verification of Licensure: Applicants who are licensed in another state must submit this form to verify their current license status. This helps ensure that all applicants meet the necessary standards.
  • Background Check Authorization: This form grants permission for the Arizona Board of Nursing to conduct a criminal background check. It is a crucial step in assessing the suitability of applicants for licensure.
  • Credential Evaluation Service (CES) Report: For applicants educated outside of the United States, a CES report is often required. This document evaluates the applicant's educational credentials to ensure they meet Arizona's standards.
  • Temporary License Application: This form allows applicants to apply for a temporary nursing license while awaiting the results of their licensure exam. It provides an opportunity to begin working in the field sooner.
  • License Renewal Application: Nurses must submit this document to renew their licenses periodically. It typically requires proof of continued education and professional practice.
  • Continuing Education Documentation: This includes certificates or transcripts proving that the nurse has completed the required continuing education courses. It is essential for maintaining an active nursing license.

Each of these documents serves a specific purpose in the licensing process, ensuring that the standards for nursing practice are upheld. Understanding and preparing these forms can help streamline the application process for aspiring nurses in Arizona.

Similar forms

  • State Medical License Application: Similar to the Arizona Board of Nursing License form, the State Medical License Application requires applicants to provide personal information, educational background, and proof of clinical training. Both documents ensure that applicants meet specific qualifications necessary for practice in their respective fields.
  • Certified Nursing Assistant (CNA) Certification: This certification form shares similarities with the nursing license application in that both require proof of completion of a training program and a competency exam. They also ensure that applicants understand the ethical and professional standards required in healthcare settings.
  • Pharmacy Technician License Application: Like the Arizona Board of Nursing License form, this application demands detailed personal information, educational qualifications, and background checks. Both documents aim to verify that applicants are suitable for their roles in healthcare and patient safety.
  • Physical Therapy License Application: This application is similar in that it requires proof of education, clinical experience, and successful completion of a licensing exam. Both forms focus on ensuring that practitioners have the necessary skills and knowledge to provide safe and effective care.
  • Occupational Therapy License Application: The Occupational Therapy License Application also mirrors the Arizona Board of Nursing License form by requiring documentation of educational credentials, supervised fieldwork experience, and passing scores on a national exam. Both processes ensure that applicants are adequately prepared to serve patients in their respective fields.

Dos and Don'ts

When filling out the Arizona Board of Nursing License form, it is crucial to follow specific guidelines to ensure a smooth application process. Below are four essential dos and don'ts.

  • Do provide accurate and complete information. Inaccuracies can lead to delays or denials.
  • Do double-check all required documentation before submission. Missing documents can result in your application being returned.
  • Don't leave any sections of the form blank. Every question must be answered to avoid complications.
  • Don't submit your application without reviewing it thoroughly. Errors can hinder your chances of obtaining your license.

Misconceptions

  • Misconception 1: All nursing programs in Arizona are automatically accredited.
  • Not all nursing programs receive automatic accreditation. Programs must meet specific standards set by recognized accrediting agencies to gain approval.

  • Misconception 2: Only registered nurses need to apply for a license.
  • Both registered nurses and practical nurses must obtain a license to practice in Arizona. Each has distinct requirements and processes.

  • Misconception 3: A temporary license allows unlimited practice.
  • A temporary license has restrictions and is typically valid for a limited time. It does not grant the same privileges as a full license.

  • Misconception 4: Once licensed, nurses do not need to renew their license.
  • Licenses must be renewed periodically. Continuing education and other requirements must be met to maintain licensure.

  • Misconception 5: Background checks are optional for licensure.
  • Background checks are mandatory for all nursing license applicants in Arizona. This ensures the safety and integrity of the nursing profession.

  • Misconception 6: All nursing licenses are valid indefinitely.
  • Nursing licenses have an expiration date and must be renewed to remain valid. Failure to renew can result in the loss of the license.

  • Misconception 7: The Arizona Board of Nursing does not consider out-of-state licenses.
  • The Board does recognize out-of-state licenses through a process called endorsement, allowing qualified applicants to obtain an Arizona license.

  • Misconception 8: Practicing without a license is a minor issue.
  • Practicing nursing without a valid license is a serious offense in Arizona and can lead to legal penalties and loss of future licensure opportunities.

Key takeaways

When completing the Arizona Board of Nursing License form, consider the following key takeaways:

  • Understand the requirements: Familiarize yourself with the specific qualifications needed for licensure, including education and examination criteria.
  • Use accurate information: Ensure that all details provided on the form are correct and up-to-date to avoid delays in processing.
  • Submit supporting documents: Include all necessary documentation, such as proof of education and background checks, as outlined in the application instructions.
  • Be mindful of deadlines: Pay attention to time-frames for licensure and renewal to maintain compliance with state regulations.
  • Follow the instructions: Adhere strictly to the guidelines provided in the application form to ensure a smooth submission process.
  • Check for updates: Stay informed about any changes to the application process or requirements by regularly visiting the Arizona Board of Nursing website.
  • Seek assistance if needed: Don’t hesitate to reach out to the Board for clarification on any aspect of the application or licensure process.